Tuesday, November 23, 2021

The New New Abnormal: What Should We Do in a World Becoming Increasingly Irrational?

We Health Care Renewal (http://hcrenewal.blogspot.com) bloggers once again apologize for our chronic lack of posting on the blog. However, we remain perplexed about what contribution to make on now an old-school, long-form web-based publication.  
Our oft-stated, somewhat nuanced concerns about aspects of health care dysfunction (see: What the US "Health Care Reform" Debate Did Not Address) now seem quaint.  These included:
- threats to the integrity of the medical evidence base (eg, suppression and manipulation of research)
- distortion of health care regulation and policy (eg, through deceptive public relations practices, conflicts of interest, particularly the revolving door, and regulatory capture) 
- bad leadership and governance that might be ill-informed, mission-hostile, or corrupt
- abandonment of health care as a calling, often through the rise of the corporate physician 
- perverse incentives putting money ahead of patient care, education and research 
- the cult of leadership, which may be suffering from "CEO disease
- taboos, including the anechoic effect  now seem quaint.  Even our updated concerns about the "new normal" (see: https://hcrenewal.blogspot.com/2019/05/the-new-abnormal-in-health-care.html)  have been eclipsed.  

Back before the COVID epidemic, we tried to develop an organized picture of what we called the "new abnormal." But even that seems out of date after the onset of the COVID pandemic.

For example, we have gone from addressing relatively subtle distortions in the clinical research base (eg from manipulation of specific aspects of controlled trials, and their dissemination) by highly trained professionals working for health care corporations in the pursuit of greater product sales at higher prices to the promotion of quack cures based on outright lies and nonsensical arguments by extremist politicians sometimes with the support of snake -oil salesman, often with the goals of not only selling useless or harmful nostrums but of promoting extremist, if not authoritarian political agendas (see early examples in posts here, here, and here).  When we argued with the subtle research manipulators, the worst we were called was "pharmascolds."  Now my Twitter comments include insults ranging from "dense" to "idiot" to unprintable.  Some people trying to promote evidence based medicine have received death threats.  And that is just a sample of what is going on, as many of you know.

Meanwhile, this is all far from anechoic.However, the old-school news items on which we used to rely, eg a corporate CEO paid disproportionately given his company's contribution to human health, have all but disappeared.

So what can we write on Health Care Renewal that will add to the light but not the heat? The HCR bloggers would appreciate your suggestions. Please add some comments below, or email me.